Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods
Background and Purpose To investigate the number and characteristics of patients eligible for endovascular treatment (EVT) determined using three different selection methods: clinical-core mismatch, target mismatch, and collateral status. Methods Using the data of consecutive patients from two prosp...
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| Format: | Article |
| Language: | English |
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Korean Stroke Society
2019-09-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2019-01578.pdf |
| _version_ | 1819030182887948288 |
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| author | Jong-Won Chung Beom Joon Kim Han-Gil Jeong Woo-Keun Seo Gyeong-Moon Kim Cheolkyu Jung Moon-Ku Han Hee-Joon Bae Oh Young Bang |
| author_facet | Jong-Won Chung Beom Joon Kim Han-Gil Jeong Woo-Keun Seo Gyeong-Moon Kim Cheolkyu Jung Moon-Ku Han Hee-Joon Bae Oh Young Bang |
| author_sort | Jong-Won Chung |
| collection | DOAJ |
| description | Background and Purpose To investigate the number and characteristics of patients eligible for endovascular treatment (EVT) determined using three different selection methods: clinical-core mismatch, target mismatch, and collateral status. Methods Using the data of consecutive patients from two prospectively maintained registries of university medical centers, the number and characteristics of patients according to the three selection methods were investigated and their correlation was analyzed. Patients with anterior circulation stroke due to occlusion of the middle cerebral and/or internal carotid artery and a National Institute of Health Stroke Scale (NIHSS) score of ≥6 points, who arrived within 8 hours or between 6 and 12 hours of symptom onset and underwent magnetic resonance imaging prior to EVT, were included. Collateral status was assessed using magnetic resonance perfusion-derived collateral flow maps. Results Three hundred thirty-five patients were investigated; the proportions of patients who were eligible and ineligible for EVT in all three selection methods were both small (n=85, 25.4%; n=54, 16.1%, respectively). The intercorrelation among the three selection methods was low (κ=0.235). The baseline NIHSS score and onset-to-selection time interval were associated with the presence of clinical-core mismatch, while the penumbra/core volume ratio and onset-to-selection time interval were related to target mismatch; none of these variables were associated with collateral status. The infarct core volume was associated with favorable profiles in all three selection methods. Conclusions Although the application of individual selection methods resulted in favorable outcomes after EVT in clinical trials, there is a significant discrepancy in EVT eligibility depending on the selection method used. |
| first_indexed | 2024-12-21T06:26:06Z |
| format | Article |
| id | doaj.art-c2d867e854c34482ae3a518666a32e38 |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-12-21T06:26:06Z |
| publishDate | 2019-09-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-c2d867e854c34482ae3a518666a32e382022-12-21T19:13:07ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052019-09-0121333233910.5853/jos.2019.01578293Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection MethodsJong-Won Chung0Beom Joon Kim1Han-Gil Jeong2Woo-Keun Seo3Gyeong-Moon Kim4Cheolkyu Jung5Moon-Ku Han6Hee-Joon Bae7Oh Young Bang8 Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaBackground and Purpose To investigate the number and characteristics of patients eligible for endovascular treatment (EVT) determined using three different selection methods: clinical-core mismatch, target mismatch, and collateral status. Methods Using the data of consecutive patients from two prospectively maintained registries of university medical centers, the number and characteristics of patients according to the three selection methods were investigated and their correlation was analyzed. Patients with anterior circulation stroke due to occlusion of the middle cerebral and/or internal carotid artery and a National Institute of Health Stroke Scale (NIHSS) score of ≥6 points, who arrived within 8 hours or between 6 and 12 hours of symptom onset and underwent magnetic resonance imaging prior to EVT, were included. Collateral status was assessed using magnetic resonance perfusion-derived collateral flow maps. Results Three hundred thirty-five patients were investigated; the proportions of patients who were eligible and ineligible for EVT in all three selection methods were both small (n=85, 25.4%; n=54, 16.1%, respectively). The intercorrelation among the three selection methods was low (κ=0.235). The baseline NIHSS score and onset-to-selection time interval were associated with the presence of clinical-core mismatch, while the penumbra/core volume ratio and onset-to-selection time interval were related to target mismatch; none of these variables were associated with collateral status. The infarct core volume was associated with favorable profiles in all three selection methods. Conclusions Although the application of individual selection methods resulted in favorable outcomes after EVT in clinical trials, there is a significant discrepancy in EVT eligibility depending on the selection method used.http://www.j-stroke.org/upload/pdf/jos-2019-01578.pdfendovascular treatmentselectionmismatchcollateral |
| spellingShingle | Jong-Won Chung Beom Joon Kim Han-Gil Jeong Woo-Keun Seo Gyeong-Moon Kim Cheolkyu Jung Moon-Ku Han Hee-Joon Bae Oh Young Bang Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods Journal of Stroke endovascular treatment selection mismatch collateral |
| title | Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods |
| title_full | Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods |
| title_fullStr | Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods |
| title_full_unstemmed | Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods |
| title_short | Selection of Candidates for Endovascular Treatment: Characteristics According to Three Different Selection Methods |
| title_sort | selection of candidates for endovascular treatment characteristics according to three different selection methods |
| topic | endovascular treatment selection mismatch collateral |
| url | http://www.j-stroke.org/upload/pdf/jos-2019-01578.pdf |
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